“夹心法”矫治半侧颜面短小的临床研究.docVIP

“夹心法”矫治半侧颜面短小的临床研究 　　[摘要]目的：运用下颌骨外板劈开颗粒状珊瑚羟基磷灰石充填矫治半侧颜面短小导致的下颌骨发育不良畸形，评估该方法的术后效果并分析该手术方法的优点及适用范围。方法：5例患者采用下颌骨外板劈开珊瑚羟基磷灰石人工骨植入术进行以Pruzansky- Kaban分型为I型或者IIa型的半侧颜面短小所致下颌骨发育不良畸形的矫治。治疗后随访6～24个月，通过术前、术后的摄像、头颅CT三维重建进行术后效果的评估。结果：纳入本次研究的5例患者进行了最少6个月的随访，后期没有明显的并发症发生。所有患者对术后效果表示满意。结论：下颌骨外板劈开颗粒状珊瑚羟基磷灰石人工骨植入术矫治半侧颜面短小可取得较好的临床效果，术后并发症少，珊瑚人工骨的降解吸收率也较低，是一种修复半侧颜面短小行之有效的方法。 　　[关键词]下颌骨外板劈开术；珊瑚人工骨；半侧颜面短小；夹心法；下颌骨发育不良 　　[中图分类号]R782.2 [文献标志码]A [文章编号]1008-6455（2018）05-0128-04 　　The “Sandwich” Method for Treatment of Mandibular Hypoplasia Caused by Hemifacial Microsomia 　　XU Jia， LI Xi， QIAO Jia， LIU Jian-feng， NIU Feng， GUI Lai 　　（the Sixth Department of Plastic Surgery Hospital， Chinese Academy of Medical Sciences Peking Union Medical College， Beijing 100144， China） 　　Abstract： Objective To observe the clinical effect of osteotomy of the outer mandibular cortex combined with CHA implantation for mandibular hypoplasia caused by hemifacial microsomia. To evaluate the postoperative effect of the method and analyse the range of application and the advantage of the method of the surgery may exist. Methods There were 5 patients of Pruzansky - Kaban type I or type IIa hemifacial microsomia treated with the method of osteotomy of the outer mandibular cortex combined with coralline hydroxyapatite implantation. Follow-up visits were conducted for 6 to 24 months to monitor. To observe the postoperative effect by the imaging and three-dimensional CT reconstruction. Results With the thickness of mandibular increased significantly after 6 months， significant improvements in the asymmetry of the mandible as well as in the aesthetic appearance of all the patients were observed. Conclusion On account of lower complications and bone absorption rate， the osteotomy of the outer mandibular cortex combined with CHA implantation is a useful method for hemifacial microsomia. 　　Key words： osteotomy of the outer mandibular cortex； coral； hemifacial microsomia；the “Sandwich” method； mandibular hypoplasia